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Threat worse than terror

A FLU pandemic is the most dangerous threat the United States faces today," says Richard Falkenrath, who until recently served in the Bush administration as deputy Homeland Security adviser. "It’s a bigger threat than terrorism. In fact, it’s bigger than anything I dealt with when I was in government."

One makes a threat assessment on the basis of two factors: the probability of the event, and the loss of life if it happened. On both counts, a pandemic ranks higher than a major terror attack, even one involving Weapons of Mass Destruction. A crude nuclear device would probably kill hundreds of thousands. A flu pandemic could easily kill millions.

Whether this particular virus makes the final, fatal mutation that allows it to move from human to human, one day some virus will. The basic factor that is fuelling this surge of viruses is China’s growth. (China is the natural habitat of the influenza virus.) As China develops, it urbanizes, and its forests and wetlands shrink. That forces migratory birds to gather closer together —and closer to human habitation —which increases the chances of a virus spreading from one species to the next. Also, growth means a huge rise in chicken consumption.

Across thousands of homes in China every day, chickens are slaughtered in highly unhygienic ways. "Every day the chances that this virus or another such virus will move from one species to another grow," says Laurie Garrett, author of "The Coming Plague," who has been writing brilliantly on this topic for years.

Nobody really disputes that we are badly unprepared for this threat. "If something like this pandemic were to happen today," says Falkenrath, "the government would be mostly an observer, not a manager." The government can’t even give intelligent advice to its citizens because it doesn’t actually know what to say. We don’t know whether people should stay put, leave cities, stay home or go to the nearest hospital.

During the Cold war, hundreds of people in government participated in dozens of crisis simulations of nuclear wars, accidents and incidents. These "tabletop exercises" were conducted so that if and when a real crisis hit, policymakers would not be confronting critical decisions for the first time. No such expertise exists for today’s deadliest threat.

Beyond short-term measures for this virus —mainly stocking up on Tamiflu —the only credible response is the development of countermeasures. The best response would be a general vaccine that would work against all strains of the flu. That’s a tall order, but it could be achieved. The model of the Manhattan Project is often bandied about loosely, but this is a case in which it makes sense. We need a massive biomedical project aimed at tackling these kinds of diseases, whether they’re natural or engineered by terrorists.

The total funding request for influenza-related research this year is about $119 million. To put this in perspective, we are spending well over $10 billion to research and develop ballistic-missile defenses, which protect us against an unlikely threat (even if they worked). We are spending $4.5 billion a year on R&D drawings for the Pentagon’s new joint strike fighter. Do we have our priorities right?

The final sense in which we are unprepared is that we have weak global organisations to deal with pandemics. The bird flu is a problem that began in Guangdong, China, and spread to Indonesia, Russia, Turkey, Romania and now possibly Iran. It may move next into Africa. Some of these governments are competent; others are not. Some hide information from everyone; others simply refuse to share it with the United States. We need a system that everyone will follow.

The World Health Organisation should become the global body that analyses samples, monitors viruses, evaluates cures and keeps track of the best practices. Yet the WHO leads a hand-to-mouth existence, relying on the whims and grants of governments. A year ago its flu branch had five people. Now it has 12. It needs a much, much larger staff and its own set of laboratories around the world that would allow it to fulfill this clearinghouse function. Countries have finally agreed to a new set of conventions that give the UN and the WHO some of the authority they need. And Kofi Annan has appointed one person to coordinate the global efforts to fight pandemics.

Many people believed that globalisation meant that government would become less important. But as we see, today’s world has actually made government more crucial. Only government can tackle a problem like this one, not by being big but by being smart and effective. And we need good governance not just at home but beyond. Without effective international coordination, we are doomed to failure. John Bolton once said that you could chop off 10 floors of the United Nations and we’d all be better off. Let’s hope that the scientists fighting global diseases aren’t on any of those floors.